Developing and testing a telehealth intervention to increase HIV pre-exposure prophylaxis uptake and adherence among sexual minority men in Nigeria

项目总结 背景资料。在尼日利亚，性少数族裔男性(SMM)的艾滋病毒水平高得不成比例 与普通人群相比。高依从性，每日口服暴露前预防(PrEP) 降低SMM感染艾滋病毒的风险。增加PrEP的摄取和依从性可以 大大降低了艾滋病毒发病率，但到目前为止，没有任何预防和预防措施侧重于尼日利亚的SMM。 K01应用程序的科学前提是PrEP的远程医疗交付模式可以 绕过尼日利亚SMM获得PrEP的障碍。有一个强有力的概念证明 拟议的办法，因为增加PrEP获取的远程保健干预已被证明 在美国的SMM中，可以接受并提高了PrEP的接受率和依从性，而 尼日利亚的远程医疗干预增加了对其他医疗服务的利用，没有研究表明 调查了#年向SMM提供PrEP卫生服务的可行性、可接受性和有效性 通过远程保健办法在尼日利亚开展工作。 项目概述。我的长期目标是成为一名独立研究员，在 开发和测试远程保健干预措施，以改善艾滋病毒预防和护理成果 在撒哈拉以南非洲的SMM。在第一年，我将与艾滋病毒阴性的SMM进行定性访谈 (n=20)、同伴教育者(n=20)和医疗保健提供者(n=20)在尼日利亚拉各斯确定 实施远程医疗干预的内容、格式和可预见的挑战 SMM中的预科意识、理解和坚持。在第二年，我将进行定性访谈 使用SMM(n=30)反复设计远程医疗干预，以增加PrEP的摄取和 在尼日利亚拉各斯的SMM之间的坚持。在3-5年级，我将进行随机对照试验 远程医疗干预的可行性、可接受性和初步疗效的试验(RCT) 通过90名PrEP-naive、HIV阴性的高危SMM在6个月内优化PrEP依从性 尼日利亚拉各斯。我成功地完成了拟议的研究和培训目标，这将使我 在这笔拨款的最后一年提交R01，以进行多站点RCT，以测试干预措施 功效。

PROJECT SUMMARY Background. In Nigeria, sexual minority men (SMM) have disproportionately higher levels of HIV compared to the general population. With high adherence, daily oral pre-exposure prophylaxis (PrEP) reduces risk for HIV acquisition among SMM. Increasing PrEP uptake and adherence could significantly reduce HIV incidence, but to date no PrEP intervention have focused on SMM in Nigeria. The scientific premise of this K01 application is that a telehealth delivery model for PrEP could circumvent barriers to PrEP access for SMM in Nigeria. There is a strong proof of concept for the proposed approach given that telehealth interventions to enhance PrEP access have been shown to be acceptable and have increased PrEP uptake and adherence, among SMM in the U.S. While telehealth interventions in Nigeria have increased utilization of other health services, no study has investigated the feasibility, acceptability, and efficacy of delivering PrEP health services to SMM in Nigeria through a telehealth approach. Overview of project. My long-term goal is to become an independent researcher with expertise in developing and testing telehealth interventions to improve HIV prevention and care outcomes among SMM in sub-Saharan Africa. In Year 1, I will conduct qualitative interviews with HIV-negative SMM (n=20), peer educators (n=20), and healthcare providers (n=20) in Lagos Nigeria to identify the content, format, and foreseeable challenges to implementing a telemedicine intervention to increase PrEP awareness, uptake, and adherence among SMM. In Year 2, I will conduct qualitative interviews with SMM (n=30) to iteratively design a telemedicine intervention to increase PrEP uptake and adherence among SMM in Lagos, Nigeria. In Years 3-5, I will conduct a pilot randomized controlled trial (RCT) to test the feasibility, acceptability, and preliminary efficacy of the telemedicine intervention to optimize PrEP adherence over 6 months with 90 PrEP-naïve, HIV-negative high risk SMM in Lagos, Nigeria. My successful completion of the proposed research and training aims will position me to submit a R01 in the final year of this grant to conduct a multisite, RCT to test the intervention’s efficacy.